1.北京中医药大学东直门医院 北京 100700
2.北京中医药大学循证医学中心
3.湖北中医药大学第一临床医学院
熊敏,男,在读博士生
#刘建平,男,博士,教授,博士生导师,E-mail:liujp@bucm.edu.cn
纸质出版日期:2022-11-30,
收稿日期:2022-02-15,
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熊敏, 周静威, 戴宁, 等. 基于AGREE Ⅱ的中医/中西医结合慢性肾脏病诊疗指南质量评价[J]. 现代中医临床, 2022,29(6):50-58.
XIONG Min, ZHOU Jingwei, DAI Ning, et al. A guideline quality evaluation for the diagnosis and treatment of chronic kidney diseases in traditional Chinese medicine/integrated Chinese and Western medicine based on AGREE Ⅱ[J]. Modern Chinese Clinical Medicine, 2022,29(6):50-58.
熊敏, 周静威, 戴宁, 等. 基于AGREE Ⅱ的中医/中西医结合慢性肾脏病诊疗指南质量评价[J]. 现代中医临床, 2022,29(6):50-58. DOI: 10.3969/j.issn.2095-6606.2022.06.011.
XIONG Min, ZHOU Jingwei, DAI Ning, et al. A guideline quality evaluation for the diagnosis and treatment of chronic kidney diseases in traditional Chinese medicine/integrated Chinese and Western medicine based on AGREE Ⅱ[J]. Modern Chinese Clinical Medicine, 2022,29(6):50-58. DOI: 10.3969/j.issn.2095-6606.2022.06.011.
目的
2
系统评价中医/中西医结合慢性肾脏病诊疗指南的方法学质量,为指南更新和推广提供依据。
方法
2
系统检索国内期刊发表的中医/中西医结合慢性肾脏病诊疗指南,提取和总结特征信息,运用AGREEⅡ对表达的明晰性、范围与目的、参与人员、制定严谨性、编辑独立性和应用性等6个领域进行独立质量评价,将评分结果按年份、机构、开发方法、基金资助等因素进行分层分析,并结合已发表的国内外其他病种领域指南的AGREEⅡ评价结果进行横向比较。
结果
2
共纳入19部相关指南,其中:中医指南2部,中西医结合指南17部,涉及“慢性肾衰竭”“IgA肾病”等疾病;16部为学会制定,1部为更新修订版本,4部采用循证医学方法制定,8部指南提及科研基金资助;颁布年份跨度为2008年至2020年,3部为近5年内制定。AGREE Ⅱ总体评分中表达的明晰性(52.63%)、范围与目的(42.4%)两个领域得分较高,参与人员得分(24.27%)次之,制定严谨性(19.19%)、编辑独立性(18.42%)、应用性(7.24%)三个领域得分非常低,5部(26.31%)指南被评价者“推荐使用”;分层分析中新近制定、采用循证医学方法开发流程、报告科研基金资助的指南AGREE Ⅱ评分相对较高;与相关研究结果横向比较,慢性肾脏病领域与国内心血管领域的中医/中西医指南的AGREE II评分相当,但与国际上发表指南的抽样AGREE II评价结果相差较大。
结论
2
我国中医/中西医结合慢性肾脏病诊疗指南AGREE Ⅱ评分总体较低,应更加重视循证开发的方法学原则,特别是在制定人员组成、技术流程的严谨性、利益冲突和应用性等方面提升指南质量。
Objective
2
To systematically evaluate the methodological quality of the guidelines for the diagnosis and treatment of chronic kidney diseases in traditional Chinese medicine/integrated traditional Chinese and Western medicine
so as to provide a basis for further update and promotion of the guidelines.
Methods
2
Systematical search was performed of the traditional Chinese medicine/integrated Chinese and Western medicine guidelines for chronic kidney diseases diagnosis and treatment published by Chinese journals. The information about their characteristics were extracted and summarized. Then AGREE Ⅱ was used in independent quality evaluations in six aspects including clarity of expression
scope and purpose
participants
rigor
editorial independence
and applicability. The scoring results are analyzed in layers based on the year of their publication
institution
development method
and whether they are funded or not
and are horizontally compared with the published AGREE Ⅱ evaluation results of guidelines for other diseases at home and abroad.
Results
2
A total of 19 guidelines were included
of which: 2 guidelines for traditional Chinese medicine
17 guidelines for integrated traditional Chinese and western medicine
covering diseases such as chronic renal failure and IgA nephropathy; 16 were formulated by academic societies
and 1 was an updated and revised version
4 were formulated using evidence-based medicine methods
and 8 guidelines received research funding; the guidelines were issued from 2008 to 2020
and 3 were formulated within the past 5 years. In the overall AGREE Ⅱ score
the clarity of expression (52.63%)
scope and purpose (42.4%) scored higher
followed by the score of participants (24.27%). Rigor (19.19%)
editorial independence (18.42%)
and applicability (7.24%) scores were very low
and 5 guidelines (26.31%) were "recommended for use" by the evaluators; In the stratified analysis
it was found that the AGREE Ⅱ scores of the three types of guides were relatively high: recently developed guidelines
those which used evidence-based medicine method and those funded by scientific research funds; The AGREE II scores of TCM/Integrated medicine guidelines in the field of chronic kidney diseases in China and in the cardiovascular field are equivalent
but the results are quite different with the AGREE II evaluation of international guidelines.
Conclusion
2
The AGREE Ⅱ score of the guidelines for the diagnosis and treatment of chronic kidney diseases in traditional Chinese medicine/integrated traditional Chinese and Western medicine is generally low
and more attention should be paid to evidence-based methodological principles
especially in terms of the staff
the rigor of technical processes
conflicts of interest
and applicability.
慢性肾脏病中医中西医结合指南质量评价AGREEⅡ
chronic kidney diseasetraditional Chinese medicineintegrated Chinese and Western medicineguidelinesquality EvaluationAGREE Ⅱ
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